NPIMap

Organization Active NPI

Advanced Endodontic Therapy, PC

  • Endodontics
  • Omaha, NE
National Provider Identifier
1154570745
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6675 Issued in NE
Legal business name
ADVANCED ENDODONTIC THERAPY, PC
Practice address
18015 Oak St
Suite a
Omaha, NE 68130-6093
Phone
(402) 763-4929
Fax
(402) 502-5990
NPI assigned
Sep 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jacob Lee Fimple, D.D.S., M.M.S.C.NPI 1497876684
Title
President
Phone
(402) 763-4929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 6675 NE Primary

Addresses

Primary practice location

18015 Oak St
Suite a
Omaha, NE 68130-6093

Mailing address

18015 Oak St
Suite a
Omaha, NE 68130-6093
Phone (402) 763-4929

Other names 1

  • Advanced Endodontic Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1154570745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18015 OAK ST",
            "address_2": "SUITE A",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681306093",
            "telephone_number": "402-763-4929",
            "fax_number": "402-502-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18015 OAK ST",
            "address_2": "SUITE A",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681306093",
            "telephone_number": "402-763-4929",
            "fax_number": "402-502-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ENDODONTIC THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "FIMPLE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-763-4929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.M.S.C."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NE",
            "license": "6675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Endodontic Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.